PACS:
1. n. (acronym)Picture Archiving and Communications System. A device or group of devices and associated network components designed to store and retrieve medical images.
2. n. (acronym)Pain And Constant Suffering.

Wednesday, October 05, 2011

Honey From The Cloud

This is Merge week, it seems, due in no small part to the Merge Live Client Conference 2011, going on right now in Chicago. I would have been there myself, except Merge accidentally scheduled the meeting right up against Yom Kippur (which begins the evening the conference ends, Friday, September 7) making it difficult to attend. No worries, RANZCR did the same thing this year.

Today's announcement outlines something Merge is giving away for free. While I have commented on the magnanimity of some of Merge's principals before, I think it's safe to assume that Merge hopes to attract new, paying customers with this sweet offering.

And sweet it is, at least in name. Merge's Project Honeycomb promises to become "The nation's largest medical image sharing network," and given the price, it might get there. Here is the video explanation:

Kinda cute, but how will it work? The explanation for the media is here. Basically, Honeycomb is a free repository for images, according to the press release:

Merge Healthcare (NASDAQ: MRGE), a leading provider of enterprise imaging and interoperability solutions, today announced Merge Honeycomb, a revolutionary new cloud-based service that will enable users to upload, download, view, and share medical images – at no cost.

“With Merge Honeycomb, we’re harnessing the cloud in a way that encourages and enables faster collaboration among all healthcare stakeholders, resulting in a true improvement in the delivery of care and reduction of costs,” said Jeff Surges, CEO of Merge Healthcare. “With the largest network of imaging clients by far, Merge is taking this important step to connect the healthcare industry and expand interoperability.”

Announced today at the Merge Live 2011 Client Conference, attended by over 500 healthcare professionals, Merge Honeycomb will be the nation’s largest medical imaging sharing network and is open to anyone. Merge Honeycomb will officially be launched at the Radiological Society of North America (RSNA) Conference in Chicago in November, 2011. Users can pre-register now for this free service at www.merge.com/honeycomb.aspx.

Merge Honeycomb will solve a myriad of costly healthcare challenges. It will reduce the need for duplicative scans, which costs the industry an average of $35 billion a year and exposes patients to harmful and unnecessary radiation. (According to a 2010 study by the Center for Devices and Radiological Health and the U.S. Food and Drug Administration, the radiation level in one CT scan of the abdomen is approximately the same as 400 chest x-rays.)

Merge Honeycomb will also eliminate the archaic practice of using patients as transport vehicles. The need to burn X-rays, CT Scans, MRIs and other images onto CDs will be a thing of the past. When a physician needs to view images, they can log into the image sharing network via any web browser.

It also speeds the time to treatment. Referring physicians will be able to view images in realtime and make diagnoses accordingly. And because the network is permission based, images can only be viewed by those who have been granted privilege.

It is a component of iConnect, the larger (and not free) overall package:

Merge iConnect facilitates the sharing of content and results across the continuum of care. Available in vendor-agnostic modules, Merge iConnect uniquely leverages existing investments and provides added functionality when needed to deliver access to any image, anytime, anywhere. While there are many niche imaging solutions in the market, Merge iConnect is the only comprehensive suite that delivers true interoperable image exchange and management.

With Merge iConnect, healthcare images are moving at the speed of life through the power of the cloud, enabling an enterprise imaging strategy. These images are easily archived, available on demand and accessible at the point of care, which means frustrations like waiting for images and unreadable CDs are history.

The interface looks a little "Facebook-ish" to me:

But maybe that's the intent, as everyone knows how to use Facebook. (Let's hope Merge doesn't contract with Zynga to create X-RayVille or something foolish like that!)

We all know that "The Cloud" really isn't something ephemeral in the sky, but rather a server and storage farm in some bunker somewhere. Did Merge buy its own farm (hopefully not from a Zynga user) or is it buying space from Amazon Web Services or some similar provider?

ADDENDUM:

For some reason, Merge takes its time in posting its own press releases on its own site. Global News Wire has this October 6 release:

Merge Healthcare (Nasdaq:MRGE), a leading provider of enterprise imaging and interoperability solutions, announced today that it has selected Dell as a preferred provider of cloud computing services, storage and enterprise hardware products to simplify information access, management and archiving among its portfolio of image interoperability solutions.

Merge will integrate its solutions within the DX platform, using Dell's capabilities to provide a highly-available, cost-effective VNA offering. By utilizing the data management features of the DX, iConnect VNA will offer advanced features such as federated storage, business continuance and nested image retention and deletion strategies.

lifeIMAGE enables the secure and on-demand exchange of medical imaging information from anywhere and with anyone. We provide a multi-purpose, SaaS platform to healthcare institutions, physicians, and patients to exchange information directly or integrate the information with their EHR or PHR systems. Our goal is to eliminate the need for duplicate imaging exams and avoid unnecessary radiation.

To do this, we offer applications that can be incrementally adopted to help with the transition to electronic exchange of imaging information. Our services solve image accessibility challenges inside and outside a facility’s firewall. Throughout, we are meticulous about confidentiality, privacy and HIPAA compliance.

Their solution is not free, but I have this sneaking suspicion that Merge Honeycomb, while a stand-alone module, will be far more useful and usable in the context of iConnect, and in the end won't be quite free either.

Having no hands-on experience with the new Honeycomb, I can't begin to tell you which is better, and no doubt both Merge and LifeImage will prosper with these approaches. To me, Dr. Dalai, Average Radiologist Extraordinaire, the key will be transparency. In other words, the system that gets the foreign images into MY PACS most easily wins.

Honeycomb? The folks of my generation might think of the cereal first:

The younger, more tech-savvy set might associate the term with the latest flavor of the Android OS.

I've never understood much about marketing or name-selection.

Oh, by the way, at the bottom of the press release, in the fine print, we see this disclaimer:

Merge Honeycomb as described herein is a works-in-progress. Merge Healthcare is not legally obligated to develop or continue to develop such works-in-progress that may include the features and functionality described herein.

Perhaps that's standard boilerplate language, but it seems a bit strange in a big announcement such as this. Oh well, never hurts to cover one's bases, eh?

Hat-tip to Mike Cannavo, the Once and Former PACSMan, since I don't seem to be on Merge's e-mail list these days.

I had a chance to demo the Honeycomb product directly and I am impressed. The feature set is right on for this initial product release. It has a social network "LinkedIn" feel to it and users are able to self register to create an account. A URL auth process follows and then you can access your free account. Although not verified, initial screenshots seem to show that "free" accounts can upload up to 10 GB of imaging data. Once logged in the user is presented with a log view screen of activity that has occurred with any images they have shared to other users. You can invite other users via e-mail to join Honeycomb or search for existing users. The search screen segments the search results between users you know (similar to 'friended') and global users accounts you haven't shown any relationship to (yet).

Uploading files is very easy as long as you have physical access to the DICOM files themselves. Once uploaded you can share the files to one or more users in your group. The sharing process has granular controls that allow you to decide how long the share is active for and whether or not the 'shared' users is allowed to download those files as DICOM objects or not. Either way the user can view the images through Honeycomb:

Images that are shared to end users are viewed using Merge's iConnect Access zero footprint viewer. Let me stress that this viewer is an amazing PACS image viewer. I have been involved with testing version 2.5 of the iConnect Access viewer for some time now and this week I was able to see the feature set in Access 3.0 which is in use in the Honeycomb product. It's truly a zero foot print viewer completely executed in JavaScript in the browser. Support summary: No Java needed, no ActiveX needed, yes IE, yes Chrome, yes Mozilla, yes iPhone & iPad, iffy on Android (for now) and no on Blackberry. It's an excellent browser and I regret I didn't get any screenshots for you. It has mote than ample toolset including cine, zoom, measurement tools, multiple viewports, full screen viewing. It's beautiful.

Did I mention that this is free? Are you considering any other image sharing services right now? Don't. This is free and it rocks. Just go to www.merge.com/honeycomb.aspx and sign up to be notified when the services launches next month. Here's a direct link to Merge's PDF document more details.

More information about the future phases of Merge Honeycomb came out today, too, as the implementation phases were shown at the "Merge Live!" event. Below is a screenshot from their presentation. Phase one and live usage will be in place by RSNA this year. Phases 2 & 3 relate to a tighter integration of Honeycomb to their iConnect Access platform.

Many thanks for the info, Matt!!!!

I received a comment as well from an anonymous reader (no one wants to admit reading my stuff, it seems):

What I'm curious about, is that lifeIMAGE already announced a similar offering to the American Society of Echocardiography (free), with plans to expand it to all? Not sure.

I'm not sure, either. I'll post what information I find on this. Sounds like LifeImage may have something up their collective sleeves...

Kind of tough to import images without the local gateway... I wonder when that is coming. Otherwise, I see tonds of AET/IP mismatches occurring. Downloading and then re-importing is a waste of time. On a positive note, their UI looks supoer nice! I just hope they dont focus too much on the Facebook looking stuff and forget to address the actual processes for importing, correcting PHI, doing lookups, etc.Nice stuff though!